Provider Demographics
NPI:1275943805
Name:MONTALVO SANTIAGO, ANGELICA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANGELICA
Middle Name:
Last Name:MONTALVO SANTIAGO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 STREAMSIDE CIR APT 8
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977-5819
Mailing Address - Country:US
Mailing Address - Phone:787-673-4540
Mailing Address - Fax:
Practice Address - Street 1:620 CHURCHMANS RD STE 103
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702
Practice Address - Country:US
Practice Address - Phone:302-655-2627
Practice Address - Fax:302-655-2613
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist